Nutrition and Cancer: Enteral and Parenteral Nutrition Support For Children

What is enteral and parenteral nutritional support?

Feeding tip for IVs:

A child-friendly approach is to place a puppet over the bags on the IV pole so it is not so intimidating. You can work with your child on naming their dinner partner. A “tattoo” or even a smiley face can be drawn near the site of the injection to make it less frightening.

Sometimes, even when high-calorie and high-protein foods are offered, children with cancer have trouble eating enough to meet their nutritional needs. Tube feedings may be needed to supplement your child’s diet or to serve as the sole source of nutrition to prevent malnutrition. This can involve placing a small tube through the nose, down the esophagus and leaving it either in the stomach (nasogastric or NG tube) or duodenum (nasoduodenal or the first part of the small intestine). The gastrointestinal tract or “gut” must be functioning properly before a feeding tube can be placed. Sometimes, a PEG (percutaneous endoscopic gastrostomy) tube is used instead. This is a tube inserted through the abdominal wall that rests in the stomach and is used to give nutrients to patients who cannot swallow. Or a similar tube, known as a J-tube (for jejunostomy), can be placed into the small intestine. These alternatives to oral feedings may be only temporary.

Sometimes, children undergoing treatment for cancer need total parenteral nutrition (TPN) to help meet their nutritional needs. TPN is a special mixture of glucose, protein, fat, vitamins, and minerals that are given intravenously (IV). Many people call this intravenous feedings. TPN provides the nutrients your child needs when he or she is not tolerating food by mouth, not absorbing nutrients in their gut, or needing bowel rest. The TPN solution is usually infused continuously over several hours of the day.